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Biomedical subjects

David Weldon

Publications and source records attributed to David Weldon.

6 recordsLinked to original sources
PubMed2006

Differential diagnosis of angioedema.

There are many conditions that may present with swelling that mimics angioedema. When swelling persists for greater than a few days or is unresponsive to treatment for urticaria/angioedema, other etiologies should be considered. In most instances, a thorough history and physical examination will define other etiologies. However, for more persistent conditions, further laboratory evaluation and a biopsy may be required to define the diagnosis. Rarely is a more aggressive approach required to make the diagnosis. Clinicians should remember that if the swelling does not act like angioedema, it more than likely is not angioedema.

Angioedema↗
PubMed2006

Sublingual immunotherapy: a comprehensive review.

Sublingual immunotherapy (SLIT) has been used with increasing frequency in Europe and is viewed with increasing interest by allergists in the United States. To address this interest, a Joint Task Force of the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology's Immunotherapy and Allergy Diagnostic Committees reviewed the available literature on SLIT and prepared this report. The task force concluded that despite clear evidence that SLIT is an effective treatment, many questions remained unanswered, including effective dose, treatment schedules, and overall duration of treatment. Until these have been determined, an assessment of the cost/benefit ratio of the treatment cannot be made. SLIT does appear to be associated with few serious side effects, but it has not been administered in high-risk asthmatic patients, nor in the studies reviewed has it been administered as a mixture of non-cross-reacting allergens. Furthermore, there is currently no allergy extract approved for this use in the United States, nor is there a Current Procedural Terminology code for billing purposes. All of these factors should be given careful consideration by anyone contemplating initiating SLIT treatment for their allergic patients.

Administration, Sublingual↗
PubMedDate not supplied

When your patients are itching to see you: not all hives are urticaria.

When patients present with itching and the perception that they have hives, what other processes can mimic urticaria? With the exception of urticarial vasculitis, urticaria typically lasts less than 24 to 36 hours at one site. A rash that persists longer should raise the suspicion of another inflammatory process. When the hive-like rash does not respond to antihistamines, a biopsy may reveal an alternative diagnosis. All biopsies should also be submitted for immunofluorescence to exclude atypical presentations of inflammatory bullous disease presenting with urticaria. However, even biopsies can be subject to misinterpretation and if the clinical picture does not support the biopsy, an alternative consultation with a dermatopathologist may be required. The extent of the laboratory and radiologic evaluation should be dictated by the clinician's suspicion of alternative causes for the hive(s) because rarely malignancies may present with urticaria. Common things are indeed common with urticaria and the more urticaria does not appear to be typical, the more often the clinician should consider alternative diagnoses.

Autoimmune Diseases↗
PubMedDate not supplied

Endocrinological masqueraders of allergy.

There are many endocrine conditions that can present with allergic symptoms and signs. Thyroid conditions ranging from fatigue to orbitopathy associated with Grave's disease can be confused with allergic conjunctivitis and angioedema. Autoimmune thyroid disease is commonly associated with idiopathic urticaria. Symptoms of orthostatic hypotension and intolerance often present when least expected and should be considered ahead of time to avoid confusion in treating possible systemic allergic reactions. Flushing is a frequent sign and differentiating from complaints commonly associated with allergic reactions, rosacea, and endocrinopathies is helpful in sorting out some of the more complex conditions associated with this symptom.

Diagnosis, Differential↗
PubMedDate not supplied

Chronic cough: an interactive case discussion.

The following case was presented at the Eastern Allergy Conference May 2005 to each of four small group sessions in an attempt to incorporate problem-based learning (PBL) into the curriculum of the conference for the first time in its 18-year history. Before this, the format had always been non-stop lectures for four days. The attempt to use PBL in breakout sessions was due to the well-documented improved learning experience with PBL demonstrated by multiple studies in the literature of PBL for CME. This PBL case on an adult who presents with a "chronic cough" was linked to a series of three didactic lectures to reinforce the differential diagnoses in this patient. The three lectures followed the PBL breakout sessions (during the morning of the conference) and were entitled Laryngeal Pharyngeal Reflux (LPR), Chronic Sinusitis: A Surgical Perspective and Chronic Cough. Although the best learning scenario for this case occurs when there is interaction with one's peers, review of this case and answering the questions that were posed by the facilitators can still provide a great learning experience.

Adult↗